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急性黄疸型肝炎误诊为急性胆囊炎:女患,26岁.因发热,右上腹持续性疼痛伴巩膜微黄2天,B超示胆囊壁粗糙,以急性胆囊炎收住内科.查体:T:38.6℃,巩膜微黄,心肺正常.腹软,肝肋下1.5cm,质软,脾未触及,莫菲氏征(+),经氨苄青霉素,654-2治疗3天,腹痛减轻,但见黄疸加深,消化道症状加重.查肝功能:总胆红素(TBiL)76μmol/L,TTT2u,ALT1864u,抗HAV-IgM(+),确诊为急性黄疸型甲型病毒性肝炎.转入传染科后予强力宁.
Acute jaundice hepatitis misdiagnosed as acute cholecystitis: female, aged 26. Due to fever, right upper quadrant persistent pain with yellow sclera two days, B ultrasound showed rough gallbladder wall, admitted to the hospital with acute cholecystitis Physical examination: T : 38.6 ℃, scleral yellow, normal heart and lung. Abdominal soft, rib 1.5cm, soft, spleen not touched, Murphy’s sign (+), ampicillin, 654-2 for 3 days, reduce abdominal pain, See jaundice deepened, gastrointestinal symptoms worsened.Check liver function: Total bilirubin (TBiL) 76μmol / L, TTT2u, ALT1864u, anti-HAV-IgM (+), diagnosed as acute jaundice type A viral hepatitis. Section after the strong to Ning.